Wedge-shaped vertebrae is a risk factor for symptomatic upper lumbar disc herniation

Area of Science:

• Orthopedics
• Neurosurgery
• Radiology

Background:

• The etiology and pathogenesis of upper lumbar disc herniation (ULDH) remain largely unknown.
• A common radiographic feature in ULDH patients is adjacent vertebral wedge deformation.
• Understanding the link between vertebral morphology and ULDH is crucial for diagnosis and treatment.

Purpose of the Study:

• To investigate the relationship between symptomatic upper lumbar disc herniation (ULDH) and wedge-shaped vertebrae (WSV).
• To identify radiological predictors for ULDH.
• To assess the independent risk factors associated with ULDH.

Main Methods:

• Retrospective study of 65 patients with single-level ULDH who underwent surgery.
• Analysis of clinical and radiological evaluation results.
• Comparison with a lower lumbar disc herniation group to determine differences in vertebral morphology.

Main Results:

• The incidence of WSV was significantly higher in the ULDH group (44.6%) compared to the lower lumbar disc herniation group (21.5%).
• Statistically significant differences were observed in WSV, wedging angle of the vertebrae (WAV), and thoracolumbar kyphotic angle (TL) between the groups.
• Multivariate logistic regression identified WAV (>5.35°) and TL (>8.35°) as independent predictors for ULDH.

Conclusions:

• Wedge-shaped vertebrae (WSV) are confirmed as an independent risk factor for ULDH.
• Specific thresholds for WAV (>5.35°) and TL (>8.35°) are significant predictors of ULDH.
• Combined vertebral wedge deformation and thoracolumbar kyphosis increase the risk of ULDH.